Why does the child's lower body itch?

The itching of children's lower body may be caused by eczema on the vulva or vulvovaginitis. We should take the children to the hospital for examination, pay attention to the hygiene of the children's private parts, and avoid the children touching their private parts with their hands. For the problem of itchy lower body in children, we should change their underwear frequently and check whether the vulva is congested or edematous.

Due to the anatomical characteristics of young girls, their vulva is poorly developed and cannot cover the urethral opening and vaginal vestibule, making it easy for bacteria to invade. They also have low estrogen levels, thin vaginal epithelium, little glycogen, high pH value, and few lactobacilli, making them susceptible to infection. Vaginitis in young girls often coexists with vulvitis. Vulvovaginitis is the most common gynecological disease in infants and young children. Treatment is often delayed due to factors such as their poor self-reporting ability and parental neglect.

Causes

Common pathogens include Staphylococcus, Streptococcus and Escherichia coli. Trichomonas or Candida can also cause infection. The pathogen can be transmitted through clothing, bathtubs, etc. of sick mothers, childcare workers or kindergarten children. It can also be caused by poor hygiene, unclean vulva, frequent contamination by feces or direct contact with dirt. In addition, vulva injury or scratches, especially pinworm infection, can cause inflammation. It can also be caused by mistakenly placing foreign objects in the vagina.

Clinical manifestations

Clinically, the mothers of the children often find purulent secretions on their diapers or underwear, or the children cry and make noises due to pain when urinating and seek medical attention. The main clinical symptoms are vulvar pain, itching and increased secretions. The mucous membranes of the vulva, clitoris, urethral orifice and vaginal orifice are congested, edematous, and have purulent secretions. There are often purulent dry scabs or watery marks on the underwear, and the vulva becomes red and swollen, and even the skin peels off. There are local scratches, bleeding and other phenomena. In severe cases, the labia minora may become adhered and the urine flow may become thinner. Examination may reveal that the adhesion area of ​​the labia minora is thinner and more translucent.

examine

Use a cotton swab to take vaginal secretions and check for Trichomonas and fungi, and pay attention to whether there are foreign objects in the vagina. Check stool for pinworm eggs.

diagnosis

The diagnosis can be confirmed based on clinical symptoms and bacterial test results.

Differential Diagnosis

Vulvovaginitis in infants and young children is a common disease in female infants and young children. When diagnosing, it is necessary to differentiate it from trichomonas or fungal vulvitis, pinworm vulvitis, acute gonorrhea in young girls, and vulvar eczema.

1. Trichomonas or fungal vulvitis

Since the vaginal pH of infants and young children is alkaline and lacks glycogen, it is not suitable for the reproduction and growth of fungi and Trichomonas. Therefore, fungal or Trichomonas vulvitis in infants and young children is rare. When clinical differentiation is needed, smear and culture of secretions can be done.

2. Pinworm vulvitis

An inflammation of the vulva caused by intestinal pinworms transmitted to the vulva and vagina through feces. It is characterized by extreme itching of the vulva and anus, and a large amount of thin yellow purulent secretions. Pinworms can be identified by examination of fecal eggs and by visualization of pinworms around the anus or on the vulva.

3. Acute gonorrhea in young girls

It is characterized by local pain and difficulty urinating. During examination, increased secretions may be seen, and redness, swelling and ulceration may occur in the vestibule, urethral orifice, vulva and even around the anus. Typical kidney-shaped Gram-negative diplococci may be found in the secretion smear.

treat

Specific infections should be ruled out first, and the secretions should be sent for examination for Trichomonas and fungi. If necessary, culture can be performed to identify the pathogenic bacteria and give appropriate antibiotics. Apply potassium permanganate in an appropriate proportion for local sitz bath, apply antibiotic ointment externally, and keep the vulva clean and dry.

prevention

Keep the baby's vulva clean and dry. When using diapers for babies, it is best to choose pure cotton, which is soft and breathable. It is best not to use diapers when you are not going out. Change diapers promptly after urination and defecation, and clean the vulva 1 to 2 times a day, paying special attention to cleaning and gently drying the labia and skin folds. Try not to let your child sit or lie on the floor, and as early as possible, stop them from wearing open-crotch pants, tight pants, or high socks made of synthetic fibers; clothes should be soft, loose, and comfortable. Cleanliness after urination and defecation should not be neglected. After defecation, use clean toilet paper to wipe from front to back. In addition, children's bathtubs, towels, etc. should be used by designated persons only to avoid cross infection with adults.